外泌体miRNA-135-5p通过AKT-mTOR信号通路对心肌炎患儿心肌损伤程度及预后预测价值  

The Clinical Value of Exosome miRNA-135-5p to Myocardial Injury Degree and Prognosis in Children with Viral Myocarditis by Inhibiting AKT/mTOR Signal Pathway

作　　者：王宏茂[1] 张明明[1] 林瑶[1] 石琳[1] 李晓惠[1] WANG Hong-mao;ZHANG Ming-ming;LIN Yao;LI Xiao-hui;SHI Lin(Department of Cardiovascular Diseases,Children's Hospital Affiliated to Capital Institute of Pediatrics,Beijing,100020,China)

机构地区：[1]首都儿科研究所附属儿童医院心血管内科,北京100020

出　　处：《现代生物医学进展》2024年第7期1216-1220,共5页Progress in Modern Biomedicine

基　　金：首都儿科研究所临床培育项目(LCPY-2021-10)。

摘　　要：目的:分析心肌炎患儿血清外泌体miRNA-135-5p与AKT-mTOR信号通路关系,评估外泌体miRNA-135-5p对心肌炎患儿心肌损伤程度及预后预测价值。方法:选择我院自2021年6月至2023年3月接诊的50例心肌炎患儿作为研究对象,其中15例为重症组,35例为轻症组;另外选择同期30名健康体检儿童作为对照组。使用逆转录聚合酶链式反应(RT-PCR)检测并比较3组血清外泌体miRNA-135-5p及AKT、mTORmRNA表达水平。分析心肌炎患儿血清miRNA-135-5p与AKT、mTORmRNA水平的相关性。多元Logistic回归分析心肌炎患儿病情相关的影响因素。随访6个月,评价血清外泌体miRNA-135-5p对心肌炎患儿预后不良的诊断效能。结果:重症组和轻症组血清外泌体miRNA-135-5p表达水平均高于对照组,且重症组高于轻症组(P<0.05);而重症组和轻症组AKT、mTORmRNA表达水平均低于对照组,且重症组低于轻症组(P<0.05);2组心肌炎患儿血清miR-NA-135-5p表达水平与AKT、mTORmRNA水平均呈负相关(P<0.05);经多元Logistic回归分析,血清外泌体miRNA-135-5p是病毒性心肌炎患儿病情程度的危险因素,而AKT、mTORmRNA是保护性因素(P<0.05)。经ROC曲线分析,血清miRNA-135-5p诊断心肌炎患儿预后不良的最佳截断值为3.32,预测的AUC为0.822,敏感度为86.3%,特异度为80.6%。结论:血清外泌体miR-NA-135-5p是心肌炎患儿病情的危险因素,其作用机制可能通过AKT-mTOR信号通路,对患儿的预后诊断效能较好。Objective:To analyze the serum levels of exosome miRNA-135-5p in children with viral myocarditis,and to evaluate its clinical value to the myocardial injury degree and prognosis by inhibiting AKT/mTOR signal pathway.Methods:The 50 children with viral myocarditis in our hospital were collected and divided into the two groups according to the degree of viral myocarditis,which were severe group(15 cases)and mild group(35 cases).The 30 healthy examinees were collected to control group.The serum levels of exo-some miRNA-135-5p,AKT mRNA and mTOR mRNA were detected by reverse transcription-polymerase chain reaction(RT-PCR)and compared among 3 groups.The correlations of exosome miRNA-135-5p to serum AKT mRNA and mTOR mRNA were confirmed by Pearson linear correlation analysis.The risk factors of illness degree of children with viral myocarditis to the clinical indexes were con-firmed by multivariate Logistic analysis.Follow-up 12 months,the diagnostic value of exosome miRNA-135-5p to the 12 months fol-low-up prognosis of the children with viral myocarditis were analyzed by receiver operating characteristic curves(ROC).Results:Com-pared to control group,the serum levels of exosome miRNA-135-5p in severe group and mild group were higher,and severe group high-er than mild group(P<0.05).The serum levels of AKT,mTOR mRNA in severe group and mild group were lower than control group,and severe group lower than mild group(P<0.05).The negative correlations of exosome miRNA-135-5p to serum AKT mRNA and mTOR mRNA were confirmed by Pearson linear correlation analysis(P<0.05).Multivariate Logistic analysis showed that the serum levels of exosome miRNA-135-5p were independent risk factors to the 12 months follow-up prognosis of children with viral myocarditis,but the levels of AKT mRNA and mTOR mRNA were the protective factors(P<0.05).When the cut-off point of exosome miRNA-135-5p was 3.32,the AUC was 0.822 and the sensitivity was 86.3%and specificity was 80.6%.Conclusions:The serum levels of exosome miR-NA-135-5p is the risk factor to

关 键 词：病毒性心肌炎 外泌体 miRNA-135-5p 信号通路 预后 

分 类 号：R542.21[医药卫生—心血管疾病]